Introduction Large cell neuroendocrine carcinoma of the cervix (LCNEC), a rare and aggressive malignancy, has poor survival. Due to the scarcity of specific treatment guidelines and the limitations of small retrospective studies, this study aims to assess prognostic factors and treatment outcomes in cervical LCNEC using data from both the SEER database and a Chinese multicenter registry. Methods This retrospective multicenter cohort study included 130 patients diagnosed with cervical LCNEC between 2004 and 2021, including 87 from the SEER database and 43 from the Chinese registry. We compared clinicopathological variables, treatment approaches such as surgery, chemotherapy, radiotherapy and survival outcomes. Kaplan-Meier and Cox regression analyses were employed to identify prognostic factors. Results The Chinese cohort exhibited a lower proportion of metastatic cases (13.95% compared to 49.43%, p<0.001), earlier disease stages (AJCC IV: 13.95% vs. 49.43%, p<0.001), and higher rates of surgery (76.74% vs. 56.32%, p=0.023) and chemotherapy (93.02% vs. 83.91%, p=0.147). The median overall survival was 22.0 months (95% CI: 17.0–29.5), with the Chinese cohort demonstrating superior 5-year survival (44.0% vs. 27.3%, p<0.001). Surgery was found to reduce the risk of mortality in both cohorts, particularly for locally advanced disease. Chemotherapy improved survival in the SEER cohort, while radiotherapy showed no significant benefit. Advanced T-stage and nodal involvement were identified as predictors of poor prognosis. Conclusion Surgery and chemotherapy remain cornerstone interventions for survival improvement, with surgical resection showing particularly pronounced benefits in locally advanced cases. Prospective studies are needed to optimize guidelines.
Kang et al. (Fri,) studied this question.
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